| 11. |
- Herlitz, Johan, 1949, et al.
(författare)
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Can we define patients with no chance of survival after out-of-hospital cardiac arrest?
- 2004
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Ingår i: Heart. - : BMJ. - 1468-201X .- 1355-6037. ; 90:10, s. 1114-8
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To evaluate whether subgroups of patients with no chance of survival can be defined among patients with out-of-hospital cardiac arrest. PATIENTS: Patients in the Swedish cardiac arrest registry who fulfilled the following criteria were surveyed: cardiopulmonary resuscitation (CPR) was attempted; the arrest was not crew witnessed; and patients were found in a non-shockable rhythm. SETTING: Various ambulance organisations in Sweden. DESIGN: Prospective observational study. RESULTS: Among the 16,712 patients who fulfilled the inclusion criteria, the following factors were independently associated with a lower chance of survival one month after cardiac arrest: no bystander CPR; non-witnessed cardiac arrest; cardiac arrest occurring at home; increasing interval between call for and arrival of the ambulance; and increasing age. When these factors were considered simultaneously two groups with no survivors were defined. In both groups patients were found in a non-shockable rhythm, no bystander CPR was attempted, the arrest was non-witnessed, the arrest took place at home. In one group the interval between call for and arrival of ambulance exceeded 12 minutes. In the other group patients were older than 80 years and the interval between call for and arrival of the ambulance exceeded eight minutes. CONCLUSION: Among patients who had an out-of-hospital cardiac arrest and were found in a non-shockable rhythm the following factors were associated with a low chance of survival: no bystander CPR, non-witnessed cardiac arrest, the arrest took place at home, increasing interval between call for and arrival of ambulance, and increasing age. When these factors were considered simultaneously, groups with no survivors could be defined. In such groups the ambulance crew may refrain from starting CPR.
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| 12. |
- Herlitz, Johan, 1949, et al.
(författare)
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Changes in demographic factors and mortality after out-of-hospital cardiac arrest in Sweden
- 2005
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Ingår i: Coron Artery Dis. - : Ovid Technologies (Wolters Kluwer Health). - 0954-6928 .- 1473-5830. ; 16:1, s. 51-7
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To describe changes between 1992 and 2003 in age, sex, factors at resuscitation and survival among patients suffering from out-of-hospital cardiac arrest in Sweden. METHODS: This was a prospective observational study including various ambulance organizations in Sweden. Patients suffering from out-of-hospital cardiac arrest between 1992 and 2003 included in the Swedish Cardiac Arrest Registry were followed for survival to 1 month. RESULTS: In all 19 791 cases took part in the survey. There was a slight increase in mean age from 68 to 70 years (P = 0.025) and an increase of females from 29 to 32% (P = 0.0001). There was a change in witnessed status (P < 0.0001) with an increase in crew-witnessed cases and a decrease in non-witnessed cases. There was a decrease in cases of a cardiac etiology from 75 to 61% (P < 0.0001) and a decrease in the percentage found in ventricular fibrillation from 36 to 25% (P < 0.0001). When crew-witnessed cases were excluded the proportion receiving bystander cardiopulmonary resuscitation (CPR) increased from 30 to 42% (P < 0.0001). There was a slight increase in the overall proportion of patients hospitalized alive from 16 to 20% (P = 0.032). There was no significant change in the overall proportion of survivors at 1 month after cardiac arrest (4.5% in 1992 and 5.0% in 2003). CONCLUSIONS: Among patients suffering from out-of-hospital cardiac arrest in Sweden some changes took place. The most important ones were a decrease in the proportion of patients found in ventricular fibrillation and an increase in the proportion of patients receiving bystander CPR. The proportion of patients admitted alive to hospital increased moderately, whereas the proportion of patients alive after 1 month remained unchanged.
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| 13. |
- Herlitz, Johan, 1949, et al.
(författare)
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Characteristics and outcome among children suffering from out of hospital cardiac arrest in Sweden
- 2005
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Ingår i: Resuscitation. - : Elsevier BV. - 0300-9572 .- 1873-1570. ; 64:1, s. 37-40
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To evaluate the characteristics, outcome and prognostic factors among children suffering from out of hospital cardiac arrest in Sweden. METHODS: Patients aged below 18 years suffering from out of hospital cardiac arrest which were not crew witnessed and included in the Swedish cardiac arrest registry were included in the survey. This survey included the period 1990-2001 and 60 ambulance organisations covering 85% of the Swedish population (8 million inhabitants). RESULTS: In all 457 children participated in the survey of which 32% were bystander witnessed and 68% received bystander CPR. Ventricular fibrillation was found in 6% of the cases. The overall survival to 1 month was 4%. The aetiology was sudden infant death syndrome in 34% and cardiac in 11%. When in a multivariate analysis considering age, sex, witnessed status, bystander CPR, initial rhythm, aetiology and the interval between call for, and arrival of, the ambulance and place of arrest only one appeared as an independent predictor of an increased chance of surviving cardiac arrest occurring outside home (adjusted odds ratio 8.7; 95% CL 2.2-58.1). CONCLUSION: Among children suffering from out of hospital cardiac arrest in Sweden that were not crew witnessed, the overall survival is low (4%). The chance of survival appears to be markedly increased if the arrest occurs outside the patients home compared with at home. No other strong predictors for an increased chance of survival could be demonstrated.
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| 14. |
- Herlitz, Johan, 1949, et al.
(författare)
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Decrease in the occurrence of ventricular fibrillation as the initially observed arrhythmia after out-of-hospital cardiac arrest during 11 years in Sweden
- 2004
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Ingår i: Resuscitation. - : Elsevier BV. - 0300-9572 .- 1873-1570. ; 60:3, s. 283-90
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To describe the change in the occurrence of ventricular fibrillation as initially observed arrhythmia among patients suffering from out-of-hospital cardiac arrest in Sweden. PATIENTS: All patients included in the Swedish cardiac arrest registry between 1991 until 2001. The registry covers 85% of the population in Sweden. METHODS: All patients with bystander witnessed out-of-hospital cardiac arrest included in the Swedish Cardiac Arrest Registry between 1991 and 2001 from the same ambulance organisation each year were included in the survey. RESULTS: Over 11 years, among patients in Sweden with a bystander witnessed out-of-hospital cardiac arrest in whom cardiopulmonary resuscitation (CPR) was attempted (n = 9666), the occurrence of ventricular fibrillation as the initially obseved arrhythmia decreased from 45% in 1991 to 28% in 2001 (P < 0.0001) if the arrest occurred at home, and from 57% to 41% if the arrest occurred outside home (P < 0.0001). This was found despite the fact that the proportion who received bystander CPR increased from 29% in 1991 to 39% in 2001 if the arrest occurred at home (P < 0.0001) and from 54% to 60% if the arrest occurred outside home (NS). There was a significant increase in age among patients with out-of-hospital cardiac arrest at home, no change in the estimated interval between collapse and call but an increase in the interval between call and arrival of the ambulance among patients with out-of-hospital cardiac arrest outside home. CONCLUSION: During 11 years in Sweden, there was a marked decrease in the proportion of patients found in ventricular fibrillation among patients with a bystander witnessed cardiac arrest regardless whether the arrest occurred at home or outside home. A modest increase in age and interval between call for, and arrival of, the ambulance was associated with these findings.
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| 15. |
- Herlitz, Johan, 1949, et al.
(författare)
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Efficacy of bystander CPR: intervention by lay people and by health care professionals
- 2005
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Ingår i: Resuscitation. - : Elsevier BV. - 0300-9572 .- 1873-1570. ; 66:3, s. 291-5
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Early cardiopulmonary resuscitation (CPR) by bystanders prior to the arrival of the rescue team has been shown to be associated with increased survival after out-of-hospital cardiac arrest. The aim of this survey was to evaluate the impact on survival of no bystander CPR, lay bystander CPR and professional bystander CPR. METHODS: Patients suffering an out-of-hospital cardiac arrest in Sweden between 1990 and 2002 who were given CPR and were not witnessed by the ambulance crew were included. RESULTS: In all, 29,711 patients were included, 36% of whom received bystander CPR prior to the arrival of the rescue team. Among the latter, 72% received CPR from lay people and 28% from professionals. Survival to 1 month was 2.2% among those who received no bystander CPR, 4.9% among those who received bystander CPR from lay people (p<0.0001) and 9.2% among those who received bystander CPR from professionals (p<0.0001 compared with bystander CPR by lay people). In a multivariate analysis, lay bystander CPR was associated with improved survival compared to no bystander CPR (OR: 2.04; 95% CI: 1.72-2.42), and professional bystander CPR was associated with improved survival compared to lay bystander CPR (OR: 1.37; 95% CI: 1.12-1.67). CONCLUSION: Among patients suffering an out-of-hospital cardiac arrest, bystander CPR by lay persons (excluding health care professionals) is associated with an increased chance of survival. Furthermore, there is a distinction between lay persons and health care providers; survival is higher when the latter perform bystander CPR. However, these results may not be explained by differences in the quality of CPR.
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| 16. |
- Herlitz, Johan, 1949, et al.
(författare)
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Factors associated with an increased chance of survival among patients suffering from an out-of-hospital cardiac arrest in a national perspective in Sweden
- 2005
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Ingår i: Am Heart J. - St. Louis, Mo. : Elsevier BV. - 1097-6744 .- 0002-8703. ; 149:1, s. 61-6
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To describe factors associated with an increased chance of survival among patients suffering from an out-of-hospital cardiac arrest in Sweden. PATIENTS AND METHODS: All patients suffering from an out-of-hospital cardiac arrest, which were not crew witnessed, in Sweden and in whom cardiopulmonary resuscitation (CPR) was attempted and who were registered in the Swedish Cardiac Arrest Registry. This registry covers about 85% of the Swedish population and has been running since 1990. RESULTS: In all, 33,453 patients, 71% of whom had a cardiac etiology, were included in the survey. The following were independent predictors for an increased chance of survival in order of magnitude: (1) patients found in ventricular fibrillation (odds ratio [OR] 5.3, 95% confidence limits [CL] 4.2-6.8), (2) the interval between call for and arrival of the ambulance less than or equal to the median (OR 3.6, 95% CL 2.9-4.6), (3) cardiac arrest occurred outside the home (OR 2.2, 95% CL 1.9-2.7), (4) cardiac arrest was witnessed (OR 2.0, 95% CL 1.6-2.7), (5) bystanders performing CPR before the arrival of the ambulance (OR 2.0, 95% CL 1.7-2.4), and (6) age less than or equal to the median (OR 1.6, 95% CL 1.4-2.0). When none of these factors were present, survival to 1 m was 0.4%; when all factors were present, survival was 23.8%. CONCLUSION: Among patients suffering from an out-of-hospital cardiac arrest, which were not crew witnessed, in Sweden and in whom CPR was attempted, 6 factors for an increased chance of survival could be defined. These include (1) initial rhythm, (2) delay to arrival of the rescue team, (3) place of arrest, (4) witnessed status, (5) bystander CPR, and (6) age.
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| 17. |
- Herlitz, Johan, 1949, et al.
(författare)
-
Is female sex associated with increased survival after out-of-hospital cardiac arrest?
- 2004
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Ingår i: Resuscitation. - : Elsevier BV. - 0300-9572 .- 1873-1570. ; 60:2, s. 197-203
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To evaluate survival after out-of-hospital cardiac arrest in relation to sex. METHODS: All patients with out-of-hospital cardiac arrest included in the Swedish Cardiac Arrest Registry between 1990 and 2000 in whom cardiopulmonary resuscitation (CPR) was attempted and who did not have a crew witnessed arrest were included. The registry covers 85% of the inhabitants of Sweden (approximately 8 million inhabitants). P-values were adjusted to differences in age. Survival was defined as patients being hospitalised alive and being alive one month after cardiac arrest. In all, 23,797 patients participated in the survey of which 27.9% were women. RESULTS: Among women 16.4% were hospitalised alive versus 13.2% among men ( P<0.001). After one month 3.0% among women were alive versus 3.4% among men (NS). In a multivariate analysis considering differences in age and various factors at resuscitation female sex was an independent predictor for patients being hospitalised alive (odds ratio 1.66; 95% confidence limits 1.49-1.84) and for being alive after one month (odds ratio 1.27; 95% confidence limits 1.03-1.56). Women differed from men as they were older ( P<0.001 ), had a lower prevalence of witnessed cardiac arrest ( P=0.01), a lower occurrence of bystander CPR (P<0.001), a lower occurrence of ventricular fibrillation as initial arrhythmia (P<0.001) and a lower occurrence of cardiac disease judged to be the cause of cardiac arrest ( P<0.0001 ). On the other hand they had a cardiac arrest at home more frequently ( P<0.001 ). CONCLUSION: Among patients suffering out-of-hospital cardiac arrest in Sweden which was not crew witnessed and in whom resuscitation efforts were attempted, female sex was associated with an increased survival.
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| 18. |
- Cone, Lucas, et al.
(författare)
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Pandemic Acceleration: Covid-19 and the emergency digitalization of European education
- 2022
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Ingår i: European Educational Research Journal. - : SAGE Publications. - 1474-9041. ; 21:5
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Tidskriftsartikel (refereegranskat)abstract
- With schools and universities closing across Europe, the Covid-19 lockdown left actors in the field of education battling with the unprecedented challenge of finding a meaningful way to keep the wheels of education turning online. The sudden need for digital solutions across the field of education resulted in the emergence of a variety of digital networks and collaborative online platforms. In this joint article from scholars around Europe, we explore the Covid-19 lockdowns of physical education across the European region, and the different processes of emergency digitalization that followed in their wake. Spanning perspectives from Italy, Germany, Belgium, and the Nordic countries, the article’s five cases provide a glimpse of how these processes have at the same time accelerated and consolidated the involvement of various commercial and non-commercial actors in public education infrastructures. By gathering documentation, registering dynamics, and making intimations of the crisis as it unfolded, the aim of the joint paper is to provide an opportunity for considering the implications of these accelerations and consolidations for the heterogeneous futures of European education.
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| 19. |
- Nilsson, Stefan, 1972, et al.
(författare)
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School-aged children's experiences of postoperative music medicine on pain, distress, and anxiety.
- 2009
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Ingår i: Paediatric anaesthesia. - : Wiley. - 1460-9592 .- 1155-5645. ; 19:12, s. 1184-90
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To test whether postoperative music listening reduces morphine consumption and influence pain, distress, and anxiety after day surgery and to describe the experience of postoperative music listening in school-aged children who had undergone day surgery. BACKGROUND: Music medicine has been proposed to reduce distress, anxiety, and pain. There has been no other study that evaluates effects of music medicine (MusiCure) in children after minor surgery. METHODS: Numbers of participants who required analgesics, individual doses, objective pain scores (Face, Legs, Activity, Cry, Consolability [FLACC]), vital signs, and administration of anti-emetics were documented during postoperative recovery stay. Self-reported pain (Coloured Analogue Scale [CAS]), distress (Facial Affective Scale [FAS]), and anxiety (short State-Trait Anxiety Inventory [STAI]) were recorded before and after surgery. In conjunction with the completed intervention semi-structured qualitative interviews were conducted. RESULTS: Data were recorded from 80 children aged 7-16. Forty participants were randomized to music medicine and another 40 participants to a control group. We found evidence that children in the music group received less morphine in the postoperative care unit, 1/40 compared to 9/40 in the control group. Children's individual FAS scores were reduced but no other significant differences between the two groups concerning FAS, CAS, FLACC, short STAI, and vital signs were shown. Children experienced the music as 'calming and relaxing.' CONCLUSIONS: Music medicine reduced the requirement of morphine and decreased the distress after minor surgery but did not else influence the postoperative care.
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| 20. |
- Hansson, Joacim, 1966-, et al.
(författare)
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Profession, utbildning, forskning : biblioteks- och informationsvetenskap för en stärkt bibliotekarieprofession
- 2018
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Rapport (populärvet., debatt m.m.)abstract
- Sekretariatet för nationell biblioteksstrategi vid Kungliga Biblioteket har givit de fem biblioteks- och informationsvetenskapliga utbildningarna vid Högskolan i Borås, Linnéuniversitetet, Lunds univeritet, Umeå universitet och Uppsala universitet uppdraget att utreda och formulera förslag kring utbildning och forskning för en stärkt bibliotekarieprofession. Syftet med föreliggande rapport är, att visa situationen för svensk biblioteks- och informationsvetenskap, tydliggöra relationen till bibliotekarieprofessionen och lämna strategiska förslag på hur ämnet kan förstärkas till förmån för en stärkt professionsutvecklig. En omvärldsanalys med riktning mot bibliotekssektorn görs samt en beskrivning av nuläget för biblioteks- och informationsvetenskaplig utbildning och forskning. Biblioteks- och informationsvetenskapens centrala betydelse för bibliotekarieprofessionen lyfts fram. Utbildingsprogrammen i ämnet attraherar gott om studenter och som svar på bibliotekens konstaterade behov av biblioteks- och informationsvetenskapligt utbildad personal argumenterar rapportförfattarna för möjligheten att expandera utbildningarna på kandidat- och masternivå vid samtliga fem lärosäten. Inom forskningen konstateras, att trots att ämnet idag i grunden fungerar väl finns ännu svårigheter att erhålla finansiering för professionsinriktad biblioteksforskning. Omvärldsanalysen visar upp ett behov av en tydligare struktur för kontinuerlig kompetensutveckling inom bibliotekarieprofessionen. Rapporten mynnar ut i fem strategiska förslag rörande grundutbildning, forskning och kontinuerlig kompetensutveckling:En ökning av antalet studieplatser på program på kandidat- och masternivå i biblioteks- och informationsvetenskap.Nationell forskarskola för biblioteksforskning.Inrättande av en externfinansierad professur med inriktning mot biblioteksforskning.Stärkt finansieringsstruktur för biblioteksforskning.Etablerande av en samlad nationell struktur för kontinuerlig kompetensutveckling.
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